Individual
MRS. DYNESHA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3338 COUNTRY CLUB RD STE L1-142, VALDOSTA, GA 31605-1044
(229) 531-5050
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-343296
GA
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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